SW3200801_Supplemental Info Review_20200810

Action History (UTC-05:00) Eastern Time (US & Canada)
Submit by Anonymous User 8/10/2020 3:53:23 PM (Supplemental Submittal)
Submit by Gwinn, Matt 8/11/2020 9:20:04 AM (Supplemental Info Submittal)
• The task was assigned to Gwinn, Matt 8/10/2020 3:53 PM

Submittal Dated: 8/10/2020
Please note: fields marked with a red asterisk below are required. You will not be able to submit the form until all
mandatory questions are answered.
Existing Project Information:
Rease suDDly the Derrrit nunber for this urolect.
D# * Fbrrrit Nurrber
SW3200801
Examples: SWxxxxxxx, NC Gxxxxxx, or NCSaxxxx
Facility Name:* Tim Furr Commercial Building
County: Cabarrus
Name: Jonathan A Carter
Vft is subrritting the information?
Email Address:* [e-mail]
Please upload all files that need to be submited.
dick the upload button or drag and drop files here to attach docurrent
2019-10-28-eROSION cO.pdf
147.5KB
2020-06-18-Furr-plans.pdf
16.15MB
2020-06-18-USGS map.pdf
1.03MB
2020-07-20-Narrative.pdf
79.47KB
DB 11575 PG 257.pdf
135.28KB
DB 13617 PG 286.pdf
1.19MB
SSW-SWU-1 01 -Application- DEML R-SPU Oct 2013-
609.19K6
signed.pdf
Only pdf files are accepted.
Please alert us to any confidential information contained in the uploaded documents.
Uploads contain r NO
Confidential r YES
Information * NOTE The following inforrration cannot be clairred as confidential: the narre and address of any perrrit applicant or
perrrittee, perrrit applications, permits, effluent data, inforrretion required by NR7ES application forms provided by
the Director inclusive of all forms and attachrrents [Ref. 40 CFR 122.7(b) and (c)].
Describe the attachments:

Erosion Control Permit
Construction Plans
USGS map
Narrative
Deed Book 11575 Page 257
Deed Book 13617 Page 286
Stormwater Application
* W By checking the box and signing box below, I certify that:
• I have given true, accurate, and complete information on this form;
• I agree that submission of this Supplemental Information form is a "transaction" subject to Chapter 66, Article 40 of the
NC General Statutes (the "Uniform Electronic Transactions Act')
• I agree to conduct this transaction by electronic means pursuant to Chapter 66, Article 40 of the NC General Statutes
(the "Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature; AND
• I intend to electronically sign and submit the Supplemental Information form."
Full Name:* Jonathan A. Carter
Signature:
j$umok ,f-
Date Submitted: 08/10/2020

Initial Review
Updated ID#: WFORfANT. REV1RAERSH0LLDVMFY and revise here if necessary.
SW3200801
Who needs a W Central Office
copy?* r Regional Office
Central Office Reviewer:*
Corey Anen - eads\scanen
Review Date * 08/11/2020